Anybody have recent brachytherapy?

My endometrial cancer is stage 1A, grade 2, lymph nodes and abdominal wash clear. My gyn/onc recommends 4 high dose outpatient brachytherapy treatments, which she says will take my risk of recurrence down from 5-10% to near zero. I went for the first appointment with rad/onc on Friday and really questioned her about worse-case scenario side effects. She said they've been having very few serious side effects with the new treatment techniques. She's sending me for barium bowel xrays the day before to make sure they know the exact post-op position of the intestines before treatment to avoid damage.

I've been looking through the archives here and have seen some disturbing posts about side effects, but most are from several years ago. My gyn/onc and rad/onc are both highly respected, as is the cancer center which is one of three highly-rated cancer centers in our city. I'm supposed to start treatments on 8/17, but I'm beginning to get cold feet. Does anybody have recent experience (good or bad) with high dose brachytherapy?

Thanks!

I read that the staging categories for endometrial, cervical, and vulva cancer have been revised. This is a very recent revision so I don’t know if doctors are using the new categories yet.

For endometrial cancer, Stage I is cancer contained in the uterus. But the new Stage I-A combines the old Stage I-A and I-B. So Stage I-A now includes cancer that does not invade the myometrium and cancer that invades less than 50%. Stage I-B now is cancer that has invaded 50% or more of the myometrium (what used to be Stage I-C. There is no longer a stage I-C. And if things weren’t already confusing enough….

My stage and grade, under the old system, is I-B2 but would be I-A2, the same as yours under the new system.

Do you know if your doctors are using the old or new system? If you had any myometrial invasion, and you were staged I-A, then they were using the new one.

Because my myometrial invasion was focal and no more than 10%, my gyn oncologist did not recommend brachytherapy but left the decision up to me. I read much research and agonized over what to do before deciding not to have brachytherapy. Stage I-B2 (less than 50% invasion) is a gray area and the decision on whether to undergo brachytherapy depends on other risk factors present and the leanings of the doctors and patients toward conservative or less conservative treatment.

I had 1st of 3 intravaginal treatments 4 1/2 wks post op. Almost immediately I became incontinent of urine. ( on way home form 6 min treatment ) Radiologist said it was from UTI. Gyn/onc agreed. Leaking persisted . I was referred to urologist. He treated me for uti, had foley placed , cystogram done. Negative of bladder tear etc etc , Had cat scan ordered by urologist. Found urinary system in good shape Found fluid behind Vaginal cuff. Never had any explanation for this . Anyway gyn/onc cancelled last 2 intravaginal radiation. I have to put my trust in her . will have follow up cat scan on sept 1st. I am 8mos post op. good luck

Bronzehorse -- My staging was under the new categories. I had about 25% invasion into the myometrium, so you and I had similar situations. I was given the option of simply being monitored, but I tend to be a worrier, so thought I should go for the brachytherapy.

But the stories of side effects scare me, and Kiele, your experience is exactly the sort of thing I'm afraid of. I'm really confused right now.

Thanks to both of you for your responses.

When I had first consultation with Radiation MD He assured me that the radiation was for precaution ONLY. So I do not feel bad about cancelling last 2 treatments. I kicked up quite a fuss when I was not getting answers about side effects. I have to say the UROLOGIST was the best ever. He took my story seriously !!! God Bless !!

So you have a 5 to 10% chance of reoccurrance or a 90-95% chance of NOT having a reoccurance...weight out the risk/benefit ratio..want to risk side effects that maybe irreversible for that? If you are getting cold feet or having your inner voice yell...there maybe a reason...I just got the all clear with Stage 4b cerv. cancer and I got a bad feeling about radiation and actually so did the radiologist. Me, the radiologist and the Chemo Dr. decided to put radiation on hold and just do chemo. Thank God I listened to my inner voice because as of now I no need radiation of any kind!! Have gotten second opinion? If I hadn't listened to my hunches and talk to other Dr.'s I would've had 7 weeks of unnecessary radiation. Just my experience..your call..good luck with everything

You have to do what is right for you. I was diagnosed with stage 1b, grade 1 ( old system) cancer after my hysterectomy on July 26. My doctor told me I had a 1-2 percent chance of recurrence and he felt furthr treatment would have the potential for more problems than just monitoring me. I am trusting his opinion but somewhat worried that maybe I should have asked for further treatments.

Fran

Hi Skysib,
Not sure how recent you would consider this, but I had three brachytherapy sessions nearly 2 years ago. I don't recall having any side effects from those sessions, although I did have side effects from my external radiation I was also undergoing. The most difficult from external radiation was extreme irritation to the urethra. They thought it was UTI, but I knew it felt different and tests showed it was not UTI. Extreme pain just before and during urination. Those UTI pain pills (plus antibiotics) didn't do a thing. My acupuncturist suggested drinking Aloe Vera juice, and that took the pain away within a day. But again, that was from the external radiation (symptoms started well before my brachytherapy).

I was told that having the brachytherapy in addition to external radiation would be "extra insurance" against having a recurrence of the endometrial cancer. I wanted to take every opportunity to reduce my chances for a recurrence, so I went for it. I am glad I did it, feeling like I did everything I could do.

Best of luck to you. Do what feels right to you, but just know that I am glad I had it done.

I was 1b 2 and my rad/onc said that the risks for problems with brachetherapy are certainly a consideration but that if I was going to worry that I didn't do it, I should go ahead. My husband and daughter were with me at the consult and they too thought a chance of 5-10% recurrance was low enough not to do the radiation. I sometimes feel kinda worried about it but its only been a year and I have been fine. It's a personal decision that is for sure. Don't jump into anything. I figured there is a higher chance of getting run over than recurrance.

When you are talking complications of radiation, are you talking specifically about complications of only brachytherapy? I have been following this forum for awhile and only know of a few people who have had significant radiation complications and they all had external beam radiation as well as brachytherapy.
I consider that I have had significant complications from radiation, but I feel that High Dose Brachytherapy was not the culprit.
With more advanced endo cancer you are treated with a combination of chemo and external beam radiation as well as high dose brachytherapy.
The external beam is usually done in 25 treatments to a much larger area than then brachytherapy.
The chemo also increases the risks of the radiation.
I guess I am just saying that be certain of what you are reading about as being caused by brachytherapy, because the only complication I am aware of after brachytherapy is vaginal stenosis, and the regular and early use of a dilator can alter that.
Although I have had many problems from radiation, I have never for a minute regretted doing it. It gives me comfort.
Best wishes in your decision
Janet